Medications for Epilepsy

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications are the first line of treatment for
epilepsy
. Anti-epileptic medications should only be used if the diagnosis is established. The goal of medication is to prevent epileptic seizures and to decrease the frequency and severity of seizures. The type and dosage of medication given must match the type of epilepsy you have. Dosage is important. It must balance prevention of seizures with the side effects that epileptic drugs can cause.

Often, but not always, one type of medication is tried at a time until the most effective one is found. Changes in medication are often made gradually because these changes can increase the likelihood of seizures. Good control is achieved in the majority of people.

In some cases, however, anti-epileptic medications may be used in combination. In approximately 80% of people, epileptic medication is fully or partially successful in preventing seizures. Be sure to take the medication on a regular schedule.

Prescription Medications

Carbamazepine

Tegretol

Carbatrol

Ethosuximide

Zarontin

Gabapentin

Neurontin

Lamotrigine

Lamictal

Oxcarbazepine

Trileptal

Phenytoin

Dilantin

Primidone

Mysoline

Valproic acid

Depakene

Diazepam Rectal Gel

Diastat

Vigabatrin

Sabril

Phenobarbital

Luminal

Topiramate

Topamax

Levetiracetam

Keppra

Lacosamide

Vimpat

Zonisamide

Zonegran

Rufinamide

Banzel

Tiagabine

Gabitril

Clobazam

Onfi

Ezogabine

Potiga

Carbamazepine

Common brand names include:

Tegretol

Carbatrol

Carbamazepine
prevents seizures by reducing the excitability of nerve fibers in the brain. This medicine is taken as a tablet or liquid. It is best taken at the same time or times each day. Taking carbamazepine with food or drink can help prevent stomach upset.

Possible side effects include:

Blurred vision

Rapid back and forth eyeball movements

Lightheadedness

Drowsiness

Possible reduced effectiveness of birth control pills—Your doctor will recommend that you use another form of birth control.

Interaction with birth control pills—Your doctor may need to adjust your medicine dose.

According to the Food and Drug Administration (FDA), people of Asian ancestry who have a certain gene, called HLA-B*1502, and take carbamazepine are at risk for dangerous or even fatal skin reactions. If you are of Asian descent, the FDA recommends that you get tested for this gene before taking carbamazepine. If you have been taking this medicine for a few months with no skin reactions, then you are at low risk of developing these reactions. Talk to your doctor before stopping this medicine.

Ethosuximide

Common brand name:
Zarontin

Ethosuximide
controls seizures by depressing nerve transmissions in the motor cortex, which is the part of the brain that controls muscles. The medicine is taken in liquid or capsule form. It is best taken at the same time or times each day. Taking it with food or drink can help prevent stomach upset.

Possible side effects include:

Nausea

Appetite loss

Vomiting

Fatigue

Lightheadedness

Drowsiness

Headache

Muscle pain

Rash

Change in urine color

Increased risk of suicidal thinking and behavior

Persistent fever or
sore throat
should be reported to your doctor. These symptoms may indicate a low white blood cell count due to suppressed bone marrow.

Gabapentin

Common brand name:
Neurontin

It is not known how
gabapentin
prevents convulsive seizures. But, it may work by altering the transport of amino acids in the brain. This medicine is taken in capsule form. Maintenance dosage varies. It is best taken with food or liquid to prevent stomach upset.

Possible side effects include:

Sleepiness

Lightheadedness

Fatigue

Lack of coordination

Weight gain

Rapid back and forth eyeball movements

Increased risk of suicidal thinking and behavior

Lamotrigine

Common brand name:
Lamictal

It is not known how
lamotrigine
prevents convulsive seizures. But, it may work by stabilizing nerve membranes. The medicine is taken in tablet form. Maintenance dosage varies. It is best taken with liquid to prevent stomach upset.

When you are taking lamotrigine, call your doctor right away if you have the following symptoms:

Rash—can be extremely serious and life-threatening

Fever

Flu-like symptoms

Swollen glands

An increase in your seizures

Possible side effects include:

Double or blurred vision

Clumsiness

Lightheadedness

Headache

Nausea or vomiting

Drowsiness

Reduced effectiveness of birth control pills—Your doctor will recommend that you use another form of birth control.

Increased risk of suicidal thinking and behavior

Aseptic meningitis—inflammation of the layers of tissue that surround the brain

Oxcarbazepine

Common brand name:
Trileptal

Oxcarbazepine
is believed to prevent convulsive seizures by altering the transport of amino acids in the brain and stabilizing the nerve membranes. This medicine is taken in tablet or liquid form. Maintenance dosage varies. It is best taken with liquid.

Possible side effects include:

Vision changes

Lightheadedness

Nausea or vomiting

Sleepiness

Headache

Fatigue

Reduced effectiveness of birth control pills—Your doctor will recommend that you use another form of birth control.

Increased risk of suicidal thinking and behavior

Phenytoin

Common brand name:
Dilantin

Phenytoin
prevents seizures by promoting sodium loss in nerve fibers. This inhibits nerve excitability and the spread of nerve impulses. This medicine is taken in tablet or liquid form. It is best taken with liquid at the same time each day.

Possible side effects include:

Bleeding

Swollen gums

Fever

Rash

Lightheadedness

Drowsiness

Rapid back and forth eyeball movement

Reduced effectiveness of birth control pills—Your doctor will recommend that you use another form of birth control.

Increased risk of suicidal thinking and behavior

Primidone

Common brand name:
Mysoline

Primidone
is believed to prevent seizures by stopping the spread of nerve impulses.

This medicine is taken in tablet or liquid form. It is best taken at the same time each day. It is also best taken with food or drink.

Possible side effects include:

Rash

Confusion

Rapid back and forth eyeball movement

Clumsiness

Lightheadedness

Drowsiness

Reduced effectiveness of birth control pills—Your doctor will recommend that you use another form of birth control.

Increased risk of suicidal thinking and behavior

Valproic Acid

Common brand name:
Depakene

Valproic acid
may prevent seizures by increasing concentrations of gamma aminobutyric acid. This inhibits nerve transmissions in parts of the brain. This medicine is taken in capsule or syrup form. It is best taken once a day, at the same time each day. Taking it with food or drink can help prevent stomach upset.

Diazepam Rectal Gel

Common brand name:
Diastat

Diazepam
is approved for the treatment of people with epilepsy who are affected by seizure clusters. Seizure clusters are multiple seizures that are different from the person's usual pattern. These episodes can last minutes to hours and may require emergency treatment.

Diastat can be given rectally by trained parents or other caregivers in a non-hospital setting.

Possible side effects include:

Drowsiness

Difficulty breathing

Headaches

Chemical dependence

Increased risk of suicidal thinking and behavior

Vigabatrin

Common brand name:
Sabril

Vigabatrin
is used to treat seizures in infants aged 1 month to 2 years. This type of infantile seizure is dangerous because it can happen frequently throughout the day.
Vigabatrin
can also be used in adults who have refractory complex partial seizures in combination with other anti-seizure medicines.

The medicine can cause serious side effects, including vision loss. Other side effects include:

Phenobarbital

Common brand name:
Luminal

Phenobarbital is used with other anti-epileptic medicines in people who have partial seizures or generalized convulsive seizures. But, the medicine can be prescribed to treat all types of seizures. Phenobarbital is also used for other conditions, such as tremor,
insomnia
, and
drug withdrawal
. The medicine has a very long half-life. This means that it stays in your system for a long time. It is available as a pill or given by IV.

Possible side effects include:

Depression

Sleepiness

Lightheadedness

Blurred vision

Difficulty in thinking clearly

Reduced effectiveness of birth control pills—Your doctor will recommend that you use another form of birth control.

Increased risk of suicidal thinking and behavior

Phenobarbital is a barbiturate, a type of medicine that can be addictive. To avoid withdrawal symptoms, you doctor will slowly reduce the dose when it is time for you to stop taking phenobarbital.

Topiramate

Common brand name:
Topamax

Topiramate may be prescribed with other anti-epileptic medicines or alone. The medicine is used to treat all types of seizures. To prevent stomach upset, take topiramate with food.

Possible side effects include:

Sleepiness

Blurred vision

Difficulty thinking clearly

Lightheadedness

Changes in mood

Nausea or vomiting

Numbness or tingling in hands or feet

Loss of appetite, weight loss

Reduced effectiveness of birth control pills—Your doctor will recommend that you use another form of birth control.

Levetiracetam

Common brand name:
Keppra

Levetiracetam is used to treat partial, generalized convulsive, and myoclonic seizures. The medicine is often prescribed in combination with other anti-epileptic medicine. To prevent stomach upset, take levetiracetam with food.

Lacosamide

Common brand name:
Vimpat

By affecting the central nervous system, this medicine reduces how many seizures a person has and how severe the seizures are. Given as a pill or an injection, lacosamide is usually prescribed with other anti-epileptic medicine.

Possible side effects include:

Lightheadedness

Sleepiness

Blurred vision

Difficulty thinking clearly

Headache

Nausea or vomiting

Increased risk of suicidal thinking and behavior

Zonisamide

Common brand name:
Zonegran

This medication is a mood stabilizer that works by calming the brain. It is used to prevent or control seizures. It may also be used as a treatment for
manic depression
.

Possible side effects include:

Lightheadedness

Sleepiness

Blurry vision

Unable to think clearly

Feeling nervous and excitable

Headache

Nausea

Vomiting

Not feeling hungry

Serious skin reactions, rarely

Rufinamide

Common brand name:
Banzel

This medication is used to treat seizures. It is also especially useful in the treatment of Lennox-Gastaut syndrome.

Possible side effects include:

Lightheadedness

Sleepiness

Blurry vision

Unable to think clearly

Feeling dizzy

Headache

Nausea

Vomiting

Tiagabine

Common brand name:
Gabitril

This medication is used to prevent or control seizures.
It is also useful as an add-on treatment for partial seizures.

Possible side effects include:

Increased appetite

Diarrhea

Shakiness

Feeling nervous and excitable

Lightheadedness

Sleepiness

Blurry vision

Unable to think clearly

Feeling dizzy

Difficulty moving around

Dry mouth

Nausea

Vomiting

This medicine may rarely cause seizures in patients who do not have them.

Clobazam

Common brand name:
Onfi

This medicine is used to control seizures in people with Lennox-Gastaut syndrome, a rare condition that causes severe seizures in childhood.

Take your medicine as directed. Do not change the amount or the schedule.

Do not stop taking them without talking to your doctor.

Do not share them.

Use a measuring spoon, cup, or syringe to give the right dose. Make sure it has the same measurements as the medicine. For example, if the medicine is given in milligrams (mg), the device should also say mg.

Ask what the results and side effects are. Report them to your doctor.

Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medicine and herb or dietary supplements.

Plan ahead for refills so you do not run out.

When to Contact Your Doctor

Contact your doctor if you:

Have any unusual, rare, or severe symptoms or side effects

Suffer any repeat seizures

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.